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Saturday, August 27, 2016

#26. Absolute Abolition - Pronouncing Psychiatry Dead on Arrival

This is Day 26 of our 30-day blog on the Declaration of Principles adopted by the 10th Annual Conference on Human Rights and Psychiatric Oppression held in Toronto, May 14-18, 1982. (More info here.) Today we are talking about Principle 26.

Principle 26 reads in full as follows:

We believe that the psychiatric system cannot be reformed but must be abolished.

Basic Rationale

Oh, the co-optation runs so deep. Would you ever be tempted to think:

We shouldn't end white supremacy because there are a lot of white supremists who have helped a lot of people.

We shouldn't end misogyny, because there are a lot of good men out there.

We shouldn't end classism or management-worker exploitation, because corporate America makes products that some people benefit from.

We shouldn't end homophobia and transphobia because a lot of people have become comfortable with homophobic and transphobic practices so they need to have that as an option.

So why is it okay to keep sanism alive simply because a lot of people have become attached to their clinicians, their diagnoses, or their promoted products...?

Ok, so maybe you get rid of sanism. But does that mean psychiatry has to go too...?

In a word yes.

The short explanation is this:

Getting rid of sanism but keeping psychiatry is like saying we should stop slavery but still have slave traders.

Here is why:

By APA definition, 'Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders.' A disorder, in turn, is 'a physical or mental condition that is not normal or healthy.'
That's all pretty much tantamount to saying that psychiatry is about enforcing sanist attitudes, derived from dominant culture conceptions of health and normality. The essential premise of psychiatry is that, once you get the training and license to practice, it's okay for some people to pass judgment on the value of other people's personhood and how they express it. Moreover, it's okay for some people to substitute their judgment for others about what is right for human beings - how we should think, act, believe, understand reality and express ourselves on this planet earth.

The violation of human rights is painful and flagrant. It's bad enough that these kinds of sanist judgments are common in contemporary society. As families, friends, neighbors, schoolmates, coworkers, colleagues, we are doing this kind of thing to people who make us uncomfortable all the time. The harm, even at this garden variety social level is hardly innocuous. As most of us have experienced at one time or another, this private passing of judgment on one's worth, dignity, right to respect, regard and membership and participation as an equal member of the human family is nothing short of devastating. Adding injury to insult, such treatment results - for many of us - in being cut off from other human rights. Not uncommonly, the social marginalization is the gateway injury that further violations. If people don't like or regard you well, then it's really easy to find yourself cut off from other resources - things every human being needs to live and be well - like access to work, education, meaningful voice and participation, fair treatment, protection from predation, exposure, want and need...

The crime of psychiatry is that it takes all of this even a step further. It institutionalizes and legitimizes the process whereby those of us with unpopular beliefs, attitudes or behaviors are systematically shut out. In this system, psychiatry plays the Grand Inspector role of separating human wheat from human chaff. Those of us designated as chaff are assigned labels as to strain of chaffing and then segregated into camps and classes for assorted levels of formal monitoring. The purpose of this monitoring is for some other human being (a psychiatric expert) to decide on our behalf how much of our human rights we are supposedly fit to access. It is a unilateral exercise of privilege is conferred - solely by and because of - the association with the psychiatric profession. The crux of this profession is its claim of entitlement - through its self-proclaimed medical authority - to determine the relative social worth and merit of the entire range of human diversity.

Thus, the psychiatry system is nothing less than a systematic human rights deprivation system. In this this system, psychiatrists play the role of designated gate-keeper authorities. These gate-keeper authorities judge and label whether their fellow human beings are fully deserving of human rights. Those deemed inadequate to the task are categorized according to their relative level of unfitness and then referred for the corresponding level of social control.

The recognized gatekeepers are empowered by mental health laws that only take effect if and when the categories psychiatrists themselves have created are invoked. It's a circular system whereby psychiatrists create the system of human classification that legitimizes blocking the humans so classified from accessing their basic human rights. The enabling legislation thus empowers the psychiatric system to usurp the personhood of those so labeled and to require the active recognition of their rights by a recognized psychiatric gate-keeper, along with assent, assistance and 'guidance' as to how the person can exercise their own rights.

The illegitimacy of the whole system becomes even more glaringly obvious once you begin to connect the dots as to who becomes a psychiatrist in the first place, as well as how the whole system is maintained. Once you start to grasp this, the absurdity of psychiatry being positioned as the judge of what is good and right about humanity becomes... well, it would be laughable if it weren't so painfully disturbing and devastating for so many people.

A year back, an old time survivor asked me to think, for a moment, about who becomes a psychiatrist. Then he took me on a tour of the territory from his perspective that was nothing short of eye opening. Here is the gist of it:

By definition, psychiatry is concerned with medicine, science, brains, and abnormal functioning. The kids to whom this appeals, as a general rule, are eggheads and geeks. The gods of their world are experts, scientists, researchers and academics. Their most intimate relationships are with textbooks, websites and technology, not human beings. Their appreciation for the immeasurable, qualitative realms - the feelings, warmth, mystery, expansiveness, hope, possibility that make life worth living for so many of us - is dim to none. Their understanding of these nonrational, subjective factors - emotion, intuition, inspiration, connection and how they relate to the quality of life - is dim to none. Their openness to inexplicable life phenomena - like transcendence, spirituality, even vulnerable feelings of love and longing that go to the core of the meaning of life - are dim to none.

So, this is the basic mindset - the values, orientation and natural affinity - by which the 'normality' of the rest of human experience is being judged. Point #1.

Now ramp this up a level. The reality is that it's painful to be that kid - the geek, nerd, dork, dolt - that vast numbers of pre-psychiatrists have been known to be. If you're this kind of kid, your social life is basically hell. You get excluded, marginalized, made fun of by your peers. You feel out of place, socially awkward, unrecognized. You are judged as strange or extreme or weird - and strung up by your underwear in locker rooms - for your honest interests and talents. You get routinely ignored by homecoming queens and humiliated by the jocks who make up the popular crowd.

All of this means you can't wait to get to college. You escape to academia, where finally you feel at home. Other co-eds are off partying, but you're taking the hardest courses. It's a tough and grueling row to hoe. But no matter. The approval of your professors and your admission to med school is more than reward enough.

Finally you become a doctor. Now, really you've arrived. Not only does everyone give you the acclaim you always knew you deserved. Pharma courts you. The offer you lavish gifts, lavish praise. Your intellect and achievement are endlessly applauded. Your every utterance in the hospital hierarchy is treated as the word of god.

And, you owe it all to science. Science, yes, science has vindicated your existence. You knew it all along - that the rational would and must prevail. All those inexact, fuzzy thinkers operating by all those arbitrary, unspoken, immeasurable social feeling thingies - now, finally, they will get their just desserts. There is no room for them in the scholarly domain of medical psychiatry. No, no no. The field of medical psychiatry is and shall forever be ruled by minds, fine ones, sound ones, beating only to one beat, the very predictable, measurable, logical, exacting heartbeat of science.

Another way of saying, psychiatry is an authority unto itself. Enter the hospital and you entire an empire. Woe to those who dishonor the empire of medicine. Woe to those who fail to pay homage to the emperors of expertise. Untold shall be their punishment, endless misery shall be their days. Truly, hell had no fury like a doctator scorned.

In other words, there really is no viewpoint allowed but the viewpoint of medicine. And, there's no sense trying to talk to psychiatry about other viewpoints. You have no credibility unless you've been to medical school or have a research degree. Not a lot of people on this planet can meet these standards on a good day. Certainly the vast majority of us won't meet them on a bad one. Yet, these are the people, and this is the values system, that has been put in charge of deciding who gets to have or keep their human rights on any given good or bad day. Point #2

But it gets even worse. These are twenty-somethings with virtually no life experience. It's not just that psychiatrists are twenty-somethings - making life-defining judgments about the merits of other people's deep and important problems of living and life crisis - with only a couple decades under their belts. It's that these particular twenty-somethings are perhaps the least qualified of all human beings to say anything meaningful about the practical problems of living that most people face. As previously noted, these particular twenty-somethings spent their lives with their heads in books avoiding the lion's share of mainstream life - including the complicated human feelings, interactions and social dynamics that most of us are trying to navigate.

So duhhh! Of course, they think it is all chemical! By nature, they're far more interested in equations than people. Moreover, they haven't participated in the vast majority of practical living so they don't have a clue what they're missing.

This is the level of actual real life preparation of those who will end up judging the relative merits of what the rest of us are experiencing. How disturbing is that? Point #3.

It even gets worse from here. Recall the painful outsider experiences (geekdom, dorkdom, locker room persecution) that precede doctor status for so many. Against this backdrop, it's safe to assume that an awful lot of pre-psychiatrists enter medical school reeling from the social blows and desperate for validation, approval and recognition. Add to this the sleep deprivation, cult-like training conditions and the financial desperation that only a first rate medical education can produce. If you were Pharma or corporate medicine, you couldn't find a riper, more vulnerable, more dupe-able audience to indoctrinate with sales pitches that you pass off as legitimate 'education.' To make your propaganda even more effective, all of the instructors are in you pocket because - as Pharma or the med tech industry - you are funding the existing university research.

Really, it's the perfect crime. You place one life-inexperienced, totally-indoctrinated twenty-something at the top of a hospital hierarchy. You make them so 'valuable' that they can never spend enough time in any one place or with any one person to actually understand what is going on. This ensures that they will learn very little and operate exactly how you trained them for a very, very long time. Point #4.

Better yet (for Pharma, shock, the medical industry), doctors are the generals of the hospital/ healthcare system. That means everyone in the healthcare hierarchy who wants to keep their job has to do what the doctor says. As a practical matter, this means that one doctor who spends three minutes a week with a psychiatric inmate effectively overrules every other staff person in the system, no matter how dedicated or trained.

This institutionalized psychiatric supremacy not only kills the voice and perspectives of the person of concern (we already knew that). It also kills the voice of every other player in this system. It kills the voice of other professions that have their own orientation and expertise to contribute. It kills the voice of other staff and workers who may have far more face-to-face and hands-on contact. It kills the voices of nonprofessional allies - including invited family, friends, teachers, coworkers and neighbors - who may have known the person for years or even a lifetime. Point #5.

Morally, this system was dead on arrival. Yet its corpse lives on, perpetuating untold destruction in zombie-like proportions wherever psychiatry rears its ugly head. This is one Walking Dead that needs to be debrained and buried.

There was never a better day for absolute abolition than today.

September 26, 2016: Conference on Principle 26

We will talk about Principle 26, including your responses, on September 26 from 9-11 PM EST. Call-in details TBA.

1 comment:

Mad psychiatric abolitionists' most important task, I think, is to help people understand that abolishing psychiatry DOES NOT mean unloading any clinicians who HAVE helped Mad people and who may even be psychiatric survivors themselves. In a Mad health care system that has unloaded the "biology/illness" model, there would still be a need for caregivers, but in a RADICALLY new and improved role that holds them WAY more accountable than they are right now. For starters, they'd need to monitor/treat people who are DETERMINED to quit their psychiatric narcotics. I, for one, could have dodged a lot of health woes if I had had the support I DESERVED for a safe abstinence from my psychiatric prescriptions. Next, ex-psychiatric clinicians would be necessary for performing the sub-clinical, but LIFESAVING tasks that can only be done by people who are skilled and obliged to work under confidentiality guidelines. Those ex-psychiatric clinicians are already set up to help Mad people manage their financial (and no, I'm not talking about holding onto anything that even resembles the exploitative "representative payee" system), legal, and educational matters. They're also prepared to do home health care and domestic work for Mad people. In a revolutionized Mad health care system, ex-psychiatric clinicians would be barred from doing only those things that they should NEVER have been allowed to do: seclusion, restraints, "limit setting", and any "treatments" that Mad people have said "NO" to. Receiving support DOES NOT need to cost Mad people their identity or their liberty.